Bacteremia is one of the most frequent and challenging nosocomial infections, is responsible for an average increase in length of stay of 2 weeks and accounts for 3.5 billion dollars annually in medical costs. There is substantial evidence that bacteremia occurs in healthy populations with manipulation of the oral mucosa, such as toothbrushing; however, the relationship of oral care to bacteremia and the clinical significance of oral care-associated bacteremia in critically ill patients have not been explored. Oral care in the ICU has the potential to reduce the risk of ventilator-associated pneumonia (VAP). Understanding the mechanism and clinical relevance of transient bacteremia of oral origin in the ICU is important in assessing the potential risks of oral care, minimizing systemic processes such as sepsis, and decreasing length of stay and mortality. The specific aims of this study are to (1) describe the effect of toothbrushing on the incidence of transient bacteremia in critical care patients; (2) investigate the relationship of dental plaque score to the incidence of bacteremia, and (3) explore the significance of transient bacteremia in the ICU for clinical outcomes. [unreadable] [unreadable] [unreadable]